日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Prenatal diagnosis of fetal heart disease by fetal echocardiography has so far focused on morphological assessment. However, more knowledge on fetal cardiac function has been accumulated recently, and the guidelines for fetal echocardiography now describe the assessment of fetal cardiac function. Conversely, the assessment of fetal cardiac function, such as that used in transthoracic echocardiography, is not always possible for the following reasons: the fetal circulation differs from the neonate’s circulation after birth; the small fetal heart must be observed through the maternal abdominal wall, which limits the image quality; the fetal position is not constant; a constant cross-sectional view cannot always be obtained; and electrocardiograms cannot usually be used on fetuses. The present review article outlines the fetal cardiac functional assessment currently used in fetal echocardiography, including the assessment of central venous pressure, ventricular contractility, ventricular diastolic and integrated ventricular functions, prognostic value of fetal heart failure, and cardiac functional assessment using new techniques, such as speckle tracking echocardiography and three-dimensional echocardiography.